Latest news with #Hiqa
Irish Times
7 days ago
- Business
- Irish Times
Six years and several controversies in, the Government is losing its faith in CHI
In 2018, then minister for health Simon Harris issued a press statement expressing his delight at the passing through the Oireachtas of the Children's Health Bill, under which there would be a single statutory entity to run paediatric healthcare in the State – Children's Health Ireland (CHI). 'This is an extraordinary opportunity to transform paediatric services for children in Ireland and will improve the experience and outcomes for children and their families,' his statement said at the time. In January 2019, it assumed control of children's health services. But just over six years later, the controversies facing the body have continued to stack up – creating concerns that the experience and outcomes for children are not as good as they should be in some services. Many of the issues centre around the orthopaedic services. In 2017, concerns were raised about the length of time children with scoliosis and spina bifida were waiting for surgery. READ MORE It was pledged no child would wait four months for surgery by the end of that year. This promise has still not been met, and clinicians question the basis behind the four-month deadline. Then came concerns around the implantation of non-medical grade springs into three children with scoliosis and spina bifida. A report was commissioned and recently published by the Health Information Quality Authority (Hiqa), which found the springs were used without ethical approval, managerial approval or the informed consent of parents. It also highlighted governance issues in the hospital, stating a failure of controls meant 'children were not protected from the risk of harm'. Last week, an independent audit examining a three-year period was published which found 60 per cent of surgeries for developmental dysplasia of the hip (DDH) in Temple Street were not necessary, while 79 per cent of the procedures in National Orthopaedic Hospital Cappagh (NOHC) did not meet the clinical threshold for surgical intervention. [ Analysis: What's in the hip surgery audit and how much harm has been done? Opens in new window ] A further report, by UK expert Selvadurai Nayagam, is being conducted into paediatric orthopaedic surgery service at CHI Temple St, CHI Crumlin, the National Orthopaedic Hospital, Cappagh, and other relevant sites in Dublin following concerns around adverse outcomes. Most recently it emerged that an internal review at Crumlin hospital from 2021 found a consultant was allegedly referring public patients to his private clinics, which he runs separately. This, according to the Sunday Times, which first reported the findings of the review, delayed operations for sick children by up to three years, with the funding for some of these clinics coming from the National treatment Purchase Fund (NTPF), which seeks to reduce hospital waiting lists. This inquiry was not sent to any senior Department of Health officials nor senior HSE officials, Minister for Health Jennifer Carroll MacNeill said, adding that the review raises 'very, very, very serious considerations for me'. Lucy Nugent took up the role as chief executive of CHI in January, and all of the issues that have emerged in recent months predate her start. Steps have also been taken to improve services; the body has accepted all findings and recommendations of the reports published to date, and are outlining plans of how they intend to enact these recommendations. But as all of this is happening, CHI is due to take over the new National Children's Hospital when it opens to patients next year. Ms Nugent expressed confidence last week at a meeting of the Public Accounts Committee that CHI would be able to commission the hospital once it is handed over to them. But given the hospital has already been beset by cost overruns and delays, it is no wonder concern abounds and serious consideration is being given about the way in which CHI will operate in the future.
Irish Times
26-05-2025
- Health
- Irish Times
High Court grants leave for doctors to bring action over State's transgender care policy
The High Court has permitted two medical practitioners to bring a challenge against the Health and Information Quality Authority's (Hiqa's) alleged failure to review the HSE 's care and management of services for gender 'nonconforming' children. Prof Donal O'Shea, a consultant endocrinologist at the National Gender Service (NGS) , and psychiatrist Dr Paul Moran, a consultant psychiatrist at the NGS, have brought the judicial review proceedings. On Monday, Ms Justice Mary Rose Gearty granted permission to Joe Jeffers SC and Brendan Hennessy BL, for the two doctors, to have a hearing of the case. Prof O'Shea and Dr Moran have challenged the HSE's referral of young people for assessment abroad, saying it poses a possible risk to children. READ MORE Ms Justice Gearty said she acknowledged that the case could be seen as one having 'divisive' elements. [ Affirming hormone treatment poses 'greater risk than benefit' for increasing numbers, says gender service consultant Opens in new window ] Prof O'Shea and Dr Moran have previously stated that they are not against a 'gender-affirming' model of care. The doctors have submitted that this model of care is typically found overseas, but that they have concerns over any inappropriate and irreversible medical treatment for patients presenting with gender identity issues. A review of this model impacts Ireland with more than 230 children and young people from Ireland experiencing gender dysphoria – where a person feels a mismatch between their biological sex and their gender identity that may cause unease, dissatisfaction, anxiety or depression. The applicants wrote to Hiqa, requesting it to undertake a statutory investigation, pursuant to section 9 of the Health Act, 2007 of the arrangements of the HSE for the management of gender nonconforming children's healthcare. Mr Jeffers has submitted: 'Hiqa was required to consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services. 'There is no evidence, or no sufficient evidence, in the decision letter whether Hiqa did in fact consider whether there were reasonable grounds to believe that there may be a serious risk to the health or welfare of the children receiving the relevant services.' [ Transgender woman says she was unable to receive 'basic healthcare' at Dublin hospital after gender surgery Opens in new window ] Mr Jeffers has also submitted that Hiqa had a care pathway established by the HSE, whereby Irish children are now being referred to a private clinic in Antwerp, Belgium, by a non-medically trained 'trans-activist'. 'The clinic in question is located in ZNA Hospital, Antwerp and is operated by an endocrinologist by the name of Dr Klink. The complainants allege the clinic had no 'model of care' or discernible operational guidelines, Mr Jeffers has submitted to the court. Mr Jeffers told the court the applicants have concerns about 'proper' care in Antwerp and over alleged lack of 'regulatory oversight' by health authorities in Ireland. Ms Justice Gearty granted permission for leave for review in the case on 'arguable grounds' and adjourned the matter to July.
Irish Examiner
21-05-2025
- Health
- Irish Examiner
CHI head 'deeply and unreservedly sorry' for non-medical devices used in children's spinal surgeries
The head of Children's Health Ireland says the organisation is 'deeply and unreservedly sorry' for some children having had non-medical devices inserted into their bodies during spinal surgery. Lucy Stewart, the recently-appointed chief executive of CHI, is to tell the Dail's Public Accounts Committee 'what happened should not have happened and children should have been protected from harm'. She will tell the committee on Thursday morning that CHI 'fully accepts the recommendations' of a recent Hiqa report regarding the practice, and will post updates on their implementation to 'ensure transparency and openness around improvements to services'. The Hiqa report found the use of metal springs during spinal surgery on children in CHI at Temple Street Hospital was 'wrong'. It found non-CE-marked springs were implanted into three children between 2020 and 2022. In the aftermath of the report's publication, Dr Jim Browne resigned as chair of the board of CHI to allow for 'renewed enthusiasm and passion to guide this great organisation'. It has also emerged many hundreds of children may have undergone unnecessary hip surgeries at children's hospitals over the past five years, with a draft report compiled for CHI by a British NHS consultant asserting nearly 80% of surgeries at one Dublin hospital may have been unnecessary. Ms Stewart will tell PAC she knows there are 'families impacted by other issues related to the orthopaedic service, specifically where reports are awaited', adding those families 'will be communicated with in the first instance' when the final reports are received, with that publication expected later this week. CHI, along with the National Paediatric Hospital Development Board will be the first witnesses at the new iteration of PAC, in light of the controversies surrounding the hip surgeries and the much-delayed new National Children's Hospital build. It emerged at last week's PAC hearing that former chief executive of CHI Eilish Hardiman, who left her role after former minister for health Stephen Donnelly declined to endorse her retention, came to a 'settlement' with the organisation in order to keep her €177,000 salary while taking over a new strategic role, with that issue likely to feature at Thursday's meeting with CHI. Meanwhile, chief officer with the National Paediatric Hospital Development Board David Gunning is to tell the committee the ongoing delays to the new NCH is 'a cause of great frustration', describing the rate of construction by main contractor BAM as being 'insufficient' to meet the agreed-upon substantial completion date of June 30 this year. Mr Gunning will add early access to the build has not yet commenced, a fact which is likely to delay the commissioning of the €2.2bn hospital even further. It emerged last weekend the Children's Hospital is now not expected to reach substantial completion before September of this year at the earliest, setting back the likely best-case-scenario go-live date of the hospital to June of next year.
Irish Times
20-05-2025
- Health
- Irish Times
‘Children can't even move in their beds they are so small': Cramped and damp conditions in some Ipas centres
Residents of an International Protection Accommodation Services (Ipas) centre in Co Westmeath have reported difficulties accessing medical appointments due to limited transport with some calling emergency services on 'occasions when out-of-hours services may have been more appropriate', said the State's health watchdog. Inspection reports from the Health Information and Quality Authority (Hiqa) into seven permanent Ipas centres also describe cramped and damp conditions in some with nappies and toiletries not provided for. An unannounced inspection of the Temple Accommodation Centre in Co Westmeath last February found that single people applying for international protection shared their bedrooms with up to three unrelated residents and 'in one case, four unrelated residents'. The allocation of accommodation did not always promote the 'privacy and dignity of residents' due to the configuration of the accommodation provided, the inspection report said. READ MORE It noted the centre was in a rural location and residents who did not have their own transport were dependent on the service providers to leave the centre. A bus service to a small town nearby was available twice daily from Monday to Thursday and once each Friday, it said. As the centre was nine kilometres from the nearest town, bicycles and scooters were not always suitable. 'Some residents reported difficulties accessing medical appointments due to limited transport and the inspectors noted that residents called emergency services on occasions when out-of-hours services may have been more appropriate,' it said. 'The service provider had not assessed these challenges or the associated risks.' Overall, Temple Accommodation Centre along with Dominick Street Complex in Co Galway, Athlone Accommodation Centre in Co Westmeath, Dublin Central Inn in Co Dublin and St Patrick's Accommodation Centre Co Monaghan had 'varying' levels of compliance with Hiqa's standards. Eglinton Centre in Co Galway and Slaney Court Apartments in Co Wicklow were found to have no non-compliances identified against the national standards. Where noncompliance with the standards was identified, providers were required to submit plans to demonstrate how they will make improvements and come into compliance with them. An unannounced inspection of Athlone Accommodation Centre in March found while it was evident upgrade works were ongoing to mobile homes, 'living arrangements were not adequate to meet the needs of some residents'. 'Mobile homes were often cramped due to their size and residents did not have suitable space in many instances to store their belongings,' the inspection report said. 'While staff did their best to improve living conditions for residents, the type of accommodation provided in this centre did not fully support some residents' rights and impacted on the wellbeing and overall quality of life for families.' Some residents said 'children can't even move in their beds they are so small', 'conditions are cramped and I've nowhere to study or complete college work'. Other residents there spoke of 'their deep concern about the damp conditions and poor ventilation' in the mobile homes, which they felt had caused 'their families to become ill'. Inspectors were told by residents that staff were doing their best to support them in this situation and that the maintenance staff team had gone to 'great efforts to remove mould from mobile homes and improve living conditions for them'. Inspectors were also informed by management and some families that, particularly in the case of secondary school places, some children had to travel 'considerable distances' to their school, due to a shortage of spaces locally. At the Dublin Central Inn, inspectors observed 'overcrowding' in some of the family units with parents and children sharing a room and 'compromising their dignity and privacy'. Two residents also noted they did not feel 'adequately supported to live a meaningful life in the centre' and some indicated a limited awareness of centre policies and procedures, the inspection report said.
Irish Times
06-05-2025
- Health
- Irish Times
Hiqa raises ‘significant concerns' about Dublin disability centre residents
The health and safety watchdog had 'significant concerns' about the wellbeing of residents in a disability centre in Dublin after it was notified of two incidents of serious injury and unexplained bruising on three residents. On Tuesday, the Health Information and Quality Authority (Hiqa) published an inspection report on a disability centre in Dublin 6W run by Cheeverstown House. In addition to the serious injuries, it said there were 31 incidents of unexplained bruising to three residents. The staff at the centre, which had 13 residents when it was inspected in January, demonstrated strong knowledge of residents' needs and engaged in kind and supportive interactions, the report found. However, 'the findings of this inspection highlighted serious shortcomings in resident safety, compatibility and access to essential services'. READ MORE The provider had submitted 31 notifications to the Office of the Chief Inspector concerning allegations, suspected or confirmed incidents of abuse in relation to three residents in the designated centre. [ Disability service providers facing funding and governance challenges Opens in new window ] During the inspection, management explained that upon reviewing the bruising incidents, it appeared that poor manual handling during personal care or assistance with dressing might have contributed to the injuries. Inspectors found 11 out of 33 staff were overdue for manual handling training. Inspectors also said they were 'not assured' that appropriate governance systems were in place to ensure the provided service was 'safe, consistent and responsive' to the needs of residents. 'Significant gaps in governance and oversight were identified, particularly in relation to risk identification and management, staff training and supervision, provider response to risks and record-keeping practices,' the report said. According to the inspector, adequate staffing resources were not in place to meet the needs of residents, and there were 'gaps and inconsistencies' in the records kept. [ Households of people with disabilities hit by extra costs and lower income Opens in new window ] 'For example, a bedrail risk assessment for one resident was reviewed, and although it had been in place since July 2021 and reviewed in July 2023, the risk assessment advised that bed rails should not be used due to high risk of injury,' the report said. 'The assessment recommended using a crash mat and sensory alarm instead. However, during the inspection, it was noted that the resident's bed had bed rails and bumpers in place.' The inspectors also found the provider had not yet ensured that all residents were in receipt of services that were appropriate to their needs. Following the inspection, the provider outlined a number of ways in which it could comply with the regulations, including reviewing all residents' assessment of needs, ensuring all staff undergo the required training and progressing transition plans of residents into more suitable accommodation. The report was one of 32 published on Tuesday, with inspectors finding a generally good level of compliance with the regulations and standards in 25 centres and noncompliance in seven centres.
